QUESTION:
Dear Dr. Heller,
I desperately need help for my 15 year old son. He is currently in therapy with a psychiatrist. The doctor has completely ruled out depression and anxiety disorder. At this time, his psychiatrist attributes his problems to anger stemming from his lack of respect for rules (home, school, civil).
I continue to question whether there is a biological reason for his behaviors -- I know I do not have a normal child. Over the last eight months, he has stolen large sums of money from both his father and I, and from one of his friends. He has admitted that he is "addicted" to stealing. He has been charged with criminal damaging, possession of marijuana, driving without a license, burglary, and attempted burglary. I know he was also involved in selling drugs but is not likely at this time since he has these other charges pending.
He is very angered by the rules I set for him, such as a 12:00 a.m. curfew, checking in with me while he is out, letting me know who he is with and where he is going. He has been diagnosed by three different professionals with ADHD, and with bipolar by one of those three. He refuses to take medication for ADHD. He has admitted to routine drug use including marijuana, LSD, and Ecstasy over the past two years. He is currently in an intensive outpatient drug program and has had 5 clean drug screenings over the last 6 weeks.
However, he has continued to break curfew, sneak out of the house during the night, and steal money. He has little interest in school or in his future. His anger is often extreme and lasts for hours. He becomes verbally abusive, throws things, but has not been physically abusive with me. He is noticeably more irritable in the morning. He lives for the day that he turns 18 and will have his "freedom." He is very good looking, has many friends, is very athletic although small for his age (50% percentile all of his life), and can be a very sweet and loving child on many days. He has had a fairly normal middle to upper middle class life with the exception of the relapse of his alcoholic father, which led to our divorce in recent years.
His father has been diagnosed with alcoholism, bi-polar, anxiety or panic disorders. He seems to accept that his father is alcoholic and agrees that our divorce was a positive decision for our family. I have two other children and my life is spent worrying about my son and dealing with all of his problems. I am totally exhausted by all of this. Your opinion will be greatly appreciated.
ANSWER:
The biggest problem seems to be lack of medically treatable diagnoses.
Childhood onset bipolar, the
BPD
and
ADHD
are the most likely. It wouldn't surprise me if some
anxiety disorders are also present.
As his parent you need to know the diagnoses, how they are made, and how they are treated.
Your concern is understandable. If he doesn't get his character turned around soon,
his "freedom" will likely mean incarceration.
He is still a minor and needs to take whatever medications you tell him to take. He
doesn't have to agree to it, he simply needs to take it - even if that choice means
psychiatric hospitalization.
